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EP3846888B1 - Systèmes de ventilation contrôlée à pression élevée - Google Patents

Systèmes de ventilation contrôlée à pression élevée Download PDF

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Publication number
EP3846888B1
EP3846888B1 EP19769663.6A EP19769663A EP3846888B1 EP 3846888 B1 EP3846888 B1 EP 3846888B1 EP 19769663 A EP19769663 A EP 19769663A EP 3846888 B1 EP3846888 B1 EP 3846888B1
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Prior art keywords
support setting
patient
percent support
target airway
ventilator
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EP19769663.6A
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German (de)
English (en)
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EP3846888A1 (fr
Inventor
Ronald Thiessen
Richard Kauc
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Covidien LP
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Covidien LP
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
    • A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes operated by electrical means
    • A61M16/022—Control means therefor
    • A61M16/024—Control means therefor including calculation means, e.g. using a processor
    • A61M16/026—Control means therefor including calculation means, e.g. using a processor specially adapted for predicting, e.g. for determining an information representative of a flow limitation during a ventilation cycle by using a root square technique or a regression analysis
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    • A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes operated by electrical means
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    • A61M16/08—Bellows; Connecting tubes ; Water traps; Patient circuits
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    • A61M2016/0018—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical
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    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/33—Controlling, regulating or measuring
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    • A61M2205/3341—Pressure; Flow stabilising pressure or flow to avoid excessive variation
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    • A61M2205/3331—Pressure; Flow
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    • A61M2230/46—Resistance or compliance of the lungs

Definitions

  • ventilator systems have long been used to provide ventilatory and supplemental oxygen support to patients. These ventilators typically comprise a source of pressurized oxygen which is fluidly connected to the patient through a conduit or tubing. As each patient may require a different ventilation strategy, modem ventilators can be customized for the particular needs of an individual patient. For example, several different ventilator modes or settings have been created to provide better ventilation for patients in various different scenarios
  • US 2014/048072 A1 discloses a ventilator system for monitoring and evaluating ventilatory data to provide useful notifications and/or recommendation.
  • This disclosure describes systems and methods for providing a proportional assist breath type during ventilation of a patient that adjusts the support provided to the patient (or the percent support setting) in response to one or more high pressure alarms.
  • the disclosure describes a novel breath type (referred to herein as a high pressure controlled proportional assist ventilation breath type) that reduces the occurrence of delivered pressures that reach or exceed the high pressure limit.
  • the features and methods described below that adjust breath delivery to reduce the occurrence of such high delivered pressure can be implemented as a new breath type, or as an adjustment or optional feature made available on an existing breath type.
  • ventilators are used to provide a breathing gas to a patient who may otherwise be unable to breathe sufficiently.
  • pressurized air and oxygen sources are often available from wall outlets.
  • ventilators may provide pressure regulating valves (or regulators) connected to centralized sources of pressurized air and pressurized oxygen.
  • the regulating valves function to regulate flow so that respiratory gas having a desired concentration of oxygen is supplied to the patient at desired pressures and rates.
  • Ventilators capable of operating independently of external sources of pressurized air are also available.
  • modem ventilators can be customized for the particular needs of an individual patient. For example, several different ventilator breath types have been created to provide better ventilation for patients in various different scenarios.
  • Effort-based breath types such as proportional assist (PA) ventilation, dynamically determine the amount of ventilatory support to deliver based on a continuous estimation/calculation of patient effort and respiratory characteristics.
  • the resulting dynamically generated profile is computed in real- or quasi-real-time and used by the ventilator as a set of points for control of applicable parameters.
  • PA proportional assist
  • Initiation and execution of an effort-based breath have two operation prerequisites: (1) detection of an inspiratory trigger; and (2) detection and measurement of an appreciable amount of patient respiratory effort to constitute a sufficient reference above a ventilator's control signal error deadband.
  • Advanced, sophisticated triggering technologies detect initiation of inspiratory efforts efficiently.
  • patient effort may be represented by the estimated inspiratory muscle pressure (patient effort) and is calculated based on measured patient inspiration flow.
  • Patient effort is utilized to calculate a target airway pressure for the inspiration.
  • the target airway pressure as used herein is the airway pressure measured at the ventilator-patient interface and is calculated on an on-going basis using patient effort according to the equation of motion. In other words, the target airway pressure is the amount of pressure delivered by the ventilator to the patient.
  • a PA breath type refers to a type of ventilation in which the ventilator acts as an inspiratory amplifier that provides pressure support based on the patient's effort.
  • the degree of amplification (the "percent support setting") during a PA breath type is set by an operator, for example as a percentage based on the patient's effort.
  • the ventilator may continuously monitor the patient's instantaneous inspiratory flow and instantaneous net lung volume, which are indicators of the patient's inspiratory effort. These signals, together with ongoing estimates of the patient's lung compliance and lung/airway resistance and the Equation of Motion (
  • Target Airway Pressure(t) E p f Q p dt + Q p R p - Patient Effort ( t ) + PEEP ), allow the ventilator to estimate/calculate a patient effort and derive therefrom a target airway pressure to provide the support that assists the patient's inspiratory muscles to the degree selected by the operator as the percent support setting.
  • PEEP as utilized herein refers to the positive end expiratory pressure.
  • Q p is the instantaneous flow inhaled by the patient, and E p and R p are the patient's respiratory elastance and resistance, respectively.
  • the patient effort is inspiratory muscle pressure.
  • the percent support setting (k) input by the operator divides the total work of breathing between the patient and the ventilator as shown in the equations below:
  • Patient Effort t 1.0 ⁇ k E p ⁇ Q p dt + Q p R p ;
  • Target Airway Pressure t k E p ⁇ Q p dt + Q p R p + PEEP .
  • Patient Effort(t) is the amount of pressure provided by the patient at a time t
  • Target airway pressure(t) is the amount of pressure provided by the ventilator at the time t
  • the bracketed term [ E p ⁇ Q p dt + Q p R p ] is the sum of flow and volume terms (elastance multiplied by the integral of flow which gives volume, plus resistance multiplied by flow)
  • k is the percent support setting (percentage of total pressure to be contributed by the ventilator) input by the operator.
  • the percent support setting is input by the operator of the ventilator and does not vary. Clinicians, typically, do not utilize a percent support setting unless operating a PA breath type. Accordingly, often times, clinicians or ventilator operators are unfamiliar with a percent support setting and need additional training to learn how to use a proportional assist breath type appropriately.
  • the PA breath type amplifies patient effort based on rapid calculations of the equation of motion.
  • the ventilator is responsible for 50% of the work of breathing, ensuring that the patient is responsible for the remaining 50%.
  • the ventilator will apply a 10 cmH 2 O support (above PEEP).
  • the ventilator will provide 4 cmH 2 O support (above PEEP) for every 1 cmH 2 O effort made by the patient.
  • the ventilator truncates the breath (preventing any more breathing gas from being delivered to the patient) or immediately switches to exhalation and issues a notification that the high pressure alarm occurred.
  • a patient on an 80% support setting i.e., 1:4 ratio of patient effort to ventilator support
  • a PEEP of 10 cm H 2 O with a high pressure limit set at 40 cmH 2 O the maximum pressure above PEEP that a ventilator can supply during a PA breath type without hitting the high pressure limit is 30 cmH 2 O.
  • a clinical problem that occurs with the PA breath type is that if a patient is temporarily strained (i.e., post suction), their effort may increase temporarily to the point that a high pressure limit is met.
  • the onset of the high pressure alarm as discussed above, truncates the breath, further agitating the patient.
  • breath truncation can lead to continual increased patient effort and resulting high pressure limiting.
  • the clinical response required to resolve such a situation is to temporarily decrease the percent support setting to a lower value (typically 50%), in order to reduce the overall target airway pressure, so that the combination of patient effort and amplification of that effort (based on % support setting) no longer activates the high pressure alarm, and allow the patient to settle.
  • this clinical response requires a clinician with the expertise to recognize the situation and the solution, and such expertise is not always immediately present at the bedside, there are times when this situation goes on longer than necessary and often the operator merely abandons the PA breath type instead.
  • HPC PA high pressure controlled proportional assist
  • the HPC PA breath type is similar to the PA breath type except that the HPC PA breath type temporarily reduces the amount of support or the percent support setting or the overall calculated target airway pressure in response to the detection of one or more consecutive high pressure alarms.
  • the HPC PA breath type functions the same as the alarm would in any other breath type.
  • an HPC PA breath type requires minimal training or education for proper use by clinicians and prevents frustration with or abandonment of a suitable ventilation mode.
  • the HPC PA breath type increases patient comfort and ventilator synchrony in response to a detection of a large patient effort when compared to other PA breath types.
  • the temporary reduction (reducing the amount of support or the percent support setting or the overall calculated target airway pressure) can be implemented as a new HPC PA breath type, or as an adjustment or optional feature made available on an existing PA breath type.
  • patient parameters are any parameters determined based on measurements taken of the patient, such as heart rate, respiration rate, a blood oxygen level (SpO 2 ), inspiratory lung flow, expiratory lunch flow, airway pressure, and etc.
  • ventilator parameters are parameters that are determined by the ventilator and/or are input into the ventilator by an operator, such as a breath type, percent support setting, PEEP, etc. Some parameters may be either ventilator and/or patient parameters depending upon whether or not they are input into the ventilator by an operator or determined by the ventilator.
  • FIG. 1 is a diagram illustrating an aspect of an exemplary ventilator 100 connected to a human patient 150.
  • Ventilator 100 includes a pneumatic system 102 (also referred to as a pressure generating system 102 ) for circulating breathing gases to and from patient 150 via the ventilation tubing system 130, which couples the patient 150 to the pneumatic system 102 via an invasive (e.g., endotracheal tube, as shown) or a non-invasive (e.g., nasal mask) patient interface 180.
  • invasive e.g., endotracheal tube, as shown
  • non-invasive e.g., nasal mask
  • Ventilation tubing system 130 may be a two-limb (shown) for carrying gases to and from the patient 150 or a one-limb circuit for carrying gases to the patient.
  • a fitting typically referred to as a "wye-fitting" 170, may be provided to couple a patient interface 180 (as shown, an endotracheal tube) to an inspiratory limb 132 and an expiratory limb 134 of the ventilation tubing system 130.
  • Pneumatic system 102 may be configured in a variety of ways.
  • pneumatic system 102 includes an expiratory module 108 coupled with the expiratory limb 134 and an inspiratory module 104 coupled with the inspiratory limb 132.
  • Compressor 106 or other source(s) of pressurized gases e.g., air, oxygen, and/or helium
  • inspiratory module 104 is coupled with inspiratory module 104 and the expiratory module 108 to provide a gas source for ventilatory support via inspiratory limb 132.
  • the inspiratory module 104 is configured to deliver gases to the patient 150 according to prescribed ventilatory settings.
  • inspiratory module 104 is configured to provide ventilation according to various breath types, e.g., via volume-control, pressure-control, HPC PA, or via any other suitable breath types.
  • the expiratory module 108 is configured to release gases from the patient's lungs according to prescribed ventilatory settings. Specifically, expiratory module 108 is associated with and/or controls an expiratory valve for releasing gases from the patient 150.
  • the ventilator 100 may also include one or more sensors 107 communicatively coupled to ventilator 100.
  • the sensors 107 may be located in the pneumatic system 102, ventilation tubing system 130, and/or on the patient 150.
  • the aspect of FIG. 1 illustrates a sensor 107 in pneumatic system 102.
  • Sensors 107 may communicate with various components of ventilator 100, e.g., pneumatic system 102, other sensors 107, processor 116, HPC PA module 118, and any other suitable components and/or modules.
  • a module as used herein refers to memory, one or more processors, storage, and/or other components of the type commonly found in command and control computing devices.
  • sensors 107 generate output and send this output to pneumatic system 102, other sensors 107, processor 116, HPC PA module 118, and any other suitable components and/or modules.
  • Sensors 107 may employ any suitable sensory or derivative technique for monitoring one or more patient parameters or ventilator parameters associated with the ventilation of a patient 150.
  • Sensors 107 may detect changes in patient parameters indicative of patient triggering, for example.
  • Sensors 107 may be placed in any suitable location, e.g., within the ventilatory circuitry or other devices communicatively coupled to the ventilator 100. Further, sensors 107 may be placed in any suitable internal location, such as, within the ventilatory circuitry or within components or modules of ventilator 100.
  • sensors 107 may be coupled to the inspiratory and/or expiratory modules for detecting changes in, for example, circuit pressure and/or flow.
  • sensors 107 may be affixed to the ventilatory tubing or may be embedded in the tubing itself.
  • sensors 107 may be provided at or near the lungs (or diaphragm) for detecting a pressure in the lungs.
  • sensors 107 may be affixed or embedded in or near wye-fitting 170 and/or patient interface 180. Indeed, any sensory device useful for monitoring changes in measurable parameters during ventilatory treatment may be employed in accordance with aspects described herein.
  • the pneumatic system 102 may include a variety of other components, including mixing modules, valves, tubing, accumulators, filters, etc.
  • Controller 110 is operatively coupled with pneumatic system 102, signal measurement and acquisition systems, and an operator interface 120 that may enable an operator to interact with the ventilator 100 (e.g., change ventilator settings, select operational modes, view monitored parameters, etc.).
  • the operator interface 120 of the ventilator 100 includes a display 122 communicatively coupled to ventilator 100.
  • Display 122 provides various input screens, for receiving clinician input, and various display screens, for presenting useful information to the clinician.
  • the display 122 is configured to include a graphical user interface (GUI).
  • GUI graphical user interface
  • the GUI may be an interactive display, e.g., a touch-sensitive screen or otherwise, and may provide various windows and elements for receiving input and interface command operations.
  • other suitable means of communication with the ventilator 100 may be provided, for instance by a wheel, keyboard, mouse, or other suitable interactive device.
  • operator interface 120 may accept commands and input through display 122.
  • Display 122 may also provide useful information in the form of various ventilatory data regarding the physical condition of a patient 150.
  • the useful information may be derived by the ventilator 100, based on data collected by a processor 116, and the useful information may be displayed to the clinician in the form of graphs, wave representations, pie graphs, text, or other suitable forms of graphic display.
  • patient data may be displayed on the GUI and/or display 122.
  • patient data may be communicated to a remote monitoring system coupled via any suitable means to the ventilator 100.
  • the display 122 may display one or more of a current patient effort, a percent support setting, a reduced percent support setting, an increased percent support setting, a notification of a reduced percent support setting, and a notification of a return to a set or desired percent support setting.
  • Controller 110 may include memory 112, one or more processors 116, storage 114, and/or other components of the type commonly found in command and control computing devices. Controller 110 may further include an HPC PA module 118 configured to deliver gases to the patient 150 according to prescribed breath types as illustrated in FIG. 1 . In alternative aspects, the HPC PA module 118 may be located in other components of the ventilator 100, such as the pressure generating system 102 (also known as the pneumatic system 102 ).
  • the memory 112 includes non-transitory, computer-readable storage media that stores and/or encodes software (such as computer executable instruction) that is executed by the processor 116 and which controls the operation of the ventilator 100.
  • the memory 112 includes one or more solid-state storage devices such as flash memory chips.
  • the memory 112 may be mass storage connected to the processor 116 through a mass storage controller (not shown) and a communications bus (not shown).
  • computer-readable storage media includes non-transitory, volatile and non-volatile, removable and non-removable media implemented in any method or technology for storage of information such as computer-readable instructions, data structures, program modules or other data.
  • computer-readable storage media includes RAM, ROM, EPROM, EEPROM, flash memory or other solid state memory technology, CD-ROM, DVD, or other optical storage, magnetic cassettes, magnetic tape, magnetic disk storage or other magnetic storage devices, other hardware memory, or any other medium which can be used to store the desired information and which can be accessed by the computer.
  • the inspiratory module 104 receives from a user a selection of a breath type such as an HPC PA breath provided by the HPC PA module 118.
  • the HPC PA module 118 receives a percent support setting from operator input or selection.
  • the HPC PA module 118 determines a percent support setting for the breath type based on operator input or selection and/or based on the occurrence of high pressure alarm.
  • the HPC PA module 118 is part of the controller 110 as illustrated in FIG. 1 .
  • the HPC PA module 118 is part of the processor 116, pneumatic system 102, and/or a separate computing device in communication with the ventilator 100.
  • An HPC PA breath is initiated by detecting an inspiratory trigger, and is executed by determining and commanding target airway pressures to be delivered to the patient 150 during inspiration.
  • a patient trigger is calculated or determined based on a measured or monitored patient inspiration flow and/or pressure.
  • Any suitable type of triggering detection for determining a patient trigger may be utilized by the ventilator 100, such as nasal detection, diaphragm detection, and/or brain signal detection. Further, the ventilator 100 may detect patient triggering via a pressure-monitoring method, a flow-monitoring method, direct or indirect measurement of neuromuscular signals, or any other suitable method. Sensors 107 suitable for this detection may include any suitable sensing device as known by a person of skill in the art for a ventilator.
  • a pressure-triggering method may involve the ventilator 100 monitoring the circuit pressure, and detecting a slight drop in circuit pressure.
  • the slight drop in circuit pressure may indicate that, in an effort to inspire, the patient's respiratory muscles are creating a slight negative pressure that in turn generates a pressure gradient between the patient's lungs and the airway opening.
  • the ventilator 100 may interpret the slight drop in circuit pressure as a patient trigger and may consequently initiate inspiration by delivering respiratory gases.
  • the ventilator 100 may detect a flow-triggered event. Specifically, the ventilator 100 may monitor the circuit flow, as described above. If the ventilator 100 detects a slight drop in the base flow through the exhalation module during exhalation, this may indicate, again, that the patient 150 is attempting to inspire. In this case, the ventilator 100 is detecting a drop in bias flow (or baseline flow) attributable to a slight redirection of gases into the patient's lungs (in response to a slightly negative pressure gradient as discussed above). Bias flow refers to a constant flow existing in the circuit during exhalation that enables the ventilator 100 to detect expiratory flow changes and patient triggering.
  • the HPC PA module 118 sends instructions for an HPC PA breath type to the inspiratory module 104.
  • a PA breath type refers to a type of ventilation in which the ventilator 100 acts as an inspiratory amplifier that provides pressure support to the patient.
  • the degree of amplification (the "percent support setting") is determined by the HPC PA module 118 based on a set or desired percent support setting, and the percent support setting or the target airway pressure may be temporarily reduced after the occurrence of high pressure alarms.
  • the percent support setting determines how much support is provided by the ventilator 100.
  • the ventilator provides a total pressure to the patient of which 70% is due to the patient effort (generation of muscle pressure) and the remaining 30% is due to the ventilator work, as estimated from the instantaneous flow or other monitored parameters based on the patient effort model used.
  • the percent support setting (k) is held constant over one breath. Every computational cycle (e.g., 5 milliseconds, 10 milliseconds, etc.), the ventilator calculates a target airway pressure, based on the patient's current effort and the percent support setting received from the HPC PA module 118.
  • the HPC PA module 118 begins inspiratory assist when a trigger is detected and/or inspiratory patient effort is detected by the HPC PA module 118. However, if the patient ceases triggering inspiration, the assist also ceases. Accordingly, in some aspects, the HPC PA module 118 includes a safety feature that has the ventilator 100 deliver a breath to the patient or switches the breath type to a non-spontaneous breath type if a patient trigger is not detected for a set period of time or based on the occurrence of a set event. This safety feature ensures that if a patient stops triggering, the patient will not stop receiving ventilation by the medical ventilator. This type of safety feature can be called backup or apnea ventilation.
  • the HPC PA module 118 determines the target airway pressure to deliver by utilizing method 200 and/or method 300 and/or method 400 as described below and/or as illustrated in FIGS. 2-4 .
  • FIG. 2 is a flow diagram illustrating a method 200 for ventilating a patient with a ventilator that utilizes a HPC PA breath type, in accordance with aspects of the disclosure.
  • the HPC PA breath type delivers a target airway pressure calculated based on a percent support setting and/or the occurrence of high pressure alarm (or the meeting of a high pressure limit).
  • the HPC PA breath type temporarily adjusts a desired or set percent support setting (the amount of support provided by the ventilator) in response to the detection of one or more high pressure alarms or the meeting of a high pressure limit.
  • adjusting the percent support setting to prevent the occurrence of additional high pressure alarms improves the treatment of a patient on a ventilator, improves clinician use of the HPC PA breath type, and/or improves patient comfort during ventilation when compared to the use of traditional PAV breath types that do not adjust the percent support setting in response to the occurrence of a high pressure alarm.
  • method 200 includes receiving operations 202 and 204.
  • Receiving operations 202 and 204 may be performed in any order, simultaneously and/or at overlapping time.
  • the ventilator retrieves or receives a desired percent support setting.
  • the desired percent support setting is input or selected by the operator.
  • the desired percent support setting is determined or selected by the ventilator based on patient parameters and/or operator input.
  • the percent support setting represents the percentage of the total work of breathing (where total work of breathing includes work of breathing done by the patient and work of breathing done by the ventilator) that the ventilator is responsible for during each breath.
  • the desired percent support setting is from 1% to 95%.
  • the desire percent support setting is 10%, 20%, 25%, 30%, 40%, 50%, 60%, 70%, 75%, 80%, or 90%. These lists are not meant to be limiting. Any suitable percent support setting to improve the health of the patient may be input by the operator and/or utilized/determined by the ventilator.
  • the ventilator retrieves and/or receives one or more monitored patient parameters based on one or more sensor measurements or senor outputs.
  • the ventilator during the parameter receiving operation 204 monitors flow and/or pressure. Sensors suitable for this detection may include any suitable sensing device as known by a person of skill in the art for a ventilator, such as an inspiratory flow sensor, inspiratory pressure sensor, an exhalation flow sensor, an exhalation pressure sensor, and/or exhalation auxiliary pressure sensor.
  • the ventilator during the receiving operation 204 monitors patient parameters every computational cycle or control cycle (e.g., 2 milliseconds, 5 milliseconds, 10 milliseconds, etc.).
  • the computational cycle is the amount of time required by the ventilator to determine and/or calculate a patient parameter.
  • normal delivery operation 206 is performed by the ventilator during method 200.
  • the ventilator determines or calculates the current patient effort.
  • the current patient effort or actual patient effort as used herein represents the amount of effort exerted by the patient over time during the delivered breath.
  • the current patient effort is calculated every control cycle based on the equation of motion and estimated patient parameters.
  • the ventilator estimates patient parameters based on the measurements directly or indirectly related to monitored patient parameters.
  • the estimated patient parameters include lung compliance (inverse of elastance) and/or lung/airway resistance.
  • the estimated lung compliance, lung elastance and/or lung/airway resistance are estimated based on monitored flow and/or the equation of motion.
  • the estimated patient parameters may be estimated by any processor found in the ventilator.
  • the ventilator calculates a target airway pressure.
  • the ventilator during normal delivery operation 206 calculates the target airway pressure based on the one or more monitored patient parameters (or the current patient effort calculated therefrom) and the desired support setting.
  • the target airway pressure is calculated for a point in the ventilation circuit that is proximal to the lung and would best assist the patient's inspiratory muscles to the degree as estimated in the initial percent support setting.
  • the ventilator delivers the target airway pressure to the patient.
  • the target airway pressure is delivered to the patient by the ventilator during operation 206 in response to the detection of the current patient effort or the current demand for new breath.
  • Method 200 also include monitor operation 208.
  • the ventilator monitors for the occurrence of a high pressure alarm or the meeting a high pressure limit. While the flow diagram shows the monitor operation 208 being perform after operation 206, the ventilator may perform monitor operation 208 at the same time as or at an overlapping time as performing receiving operations 202 and 204 and as performing normal delivery operation 206.
  • a high pressure alarm occurs or a high pressure limit is reached if the target airway pressure in the breathing circuit exceeds a set pressure limit, such as 40 cmH 2 O.
  • a set pressure limit such as 40 cmH 2 O.
  • the ventilator truncates the delivery of the target airway pressure, such that only a portion of the target airway pressure is delivered to the patient.
  • the ventilator immediately stops inspiration and begins exhalation to prevent any more pressure from being delivered to the patient during normal delivery operation 206.
  • Method 200 also includes count decision operation 210.
  • the ventilator determines if a set number of high pressure alarms have occurred in response to the delivering of the target airway pressure based on the monitoring of the high pressure alarms during operation 208.
  • the set number of high pressure alarms may be 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10. In some aspects, the set number of high pressure alarms is 1. In other aspects, the set number of high pressure alarms is 3. This list of alarm counts is not meant to be limiting. Any suitable count of high pressure alarm for lowering the percent support setting may be utilized by the ventilator during count decision operation 210.
  • the count decision is optional, but it can be employed to delay the following steps (to reduce the percent support setting) until a set number of high pressure alarms have been triggered.
  • the operation 210 may count high pressure alarms in consecutive breaths, or in non-consecutive breaths that are within a span (such as a limited time duration or limited number of breaths). For example, if the set number is 3, the operation 210 may look for high pressure alarms in 3 consecutive breaths, or in 3 out of 4 breaths, or in 3 breaths within 30 seconds. These numbers are examples only, and other numbers can be used.
  • the ventilator performs reduction operation 212. In other words, if the set number of high pressure alarms is met during count decision operation 210, the ventilator determines a new percent support setting that is less than the desired percent support setting.
  • the ventilator selects to again perform operation 206. In other words, if the set number of high pressure alarms is not met during count decision operation 210, the ventilator continues to calculate and deliver to the patient a target airway pressure based on the desired percent support setting. As such, the ventilator may deliver a plurality of different target airway pressures to the patient based on the desired percent support setting and the one or more monitored parameters before operation 212 is performed.
  • Method 200 also includes reduction operation 212.
  • the ventilator reduces the desired percent support setting to form a reduced percent support setting.
  • the desired present support setting is reduced by a set amount or is reduced to a set amount.
  • the desired present support setting may be set to 40%.
  • the desired percent support setting may be reduced by half (reduced by 50%). In this example, the desired percent support setting will affect the value of the reduced percent support setting.
  • the reduced percent support setting will be set to 45% and if the desired percent support setting is 80%, the reduced percent support setting will be set to 40%.
  • the ventilator performs reduced delivery operation 214.
  • the ventilator calculates a target airway pressure based on the reduced percent support setting and the one or more patient parameters (or the current patient effort determined therefrom) received from parameter operation 204.
  • the ventilator at reduced delivery operation 214 calculates or determines a patient effort based on one or more received patient parameters, such as estimated patient compliance and flow rate.
  • the ventilator delivers to the patient the target airway pressure calculated based on the reduced percent support setting.
  • the delivery of different target airway pressures may be differentiated from each other by the use of a descriptive term such as, "first", "second", and "third".
  • the ventilator may deliver one or more "first target airway pressures" to the patient during normal delivery operation 206, the ventilator may deliver one or more "second target airway pressures” to the patient during reduced delivery operation 214, and/or the ventilator may deliver one or more "third target airway pressures" to the patient during increased delivery operation 222.
  • Method 200 also includes high pressure decision operation 216.
  • High pressure decision operation 216 is the same or similar to count decision operation 210, except that it is performed after the reduced delivery operation 214 and/or increased delivery operation 222.
  • the ventilator determines if a set number of high pressure alarms has occurred in response to the delivering of the target airway pressure (that is calculated based on a percent support setting that is less than the desired percent support setting) based on the monitoring of the high pressure alarms during operation 208.
  • the set number of high pressure alarms may be 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10. In some aspects, the set number of high pressure alarms is 1. In other aspects, the set number of high pressure alarms is 3. This list of alarm counts is not meant to be limiting.
  • any suitable count of high pressure alarm for lowering the percent support setting may be utilized by the ventilator during high pressure decision operation 216.
  • the set number in operation 216 may be the same as or may differ from the set number in operation 210.
  • the set number in operation 216 is lower than the set number in operation 210, so that further reductions in percent support can take place more rapidly.
  • high pressure decision operation 216 if the ventilator determines that the set number of high pressure alarms has been reached, then the ventilator selects to perform reduction operation 212. In other words, if the set number of high pressure alarms is met during high pressure decision operation 216, the ventilator further reduces the percent support setting to an amount that is less than the previously reduced percent support setting. This could be reducing to another set percent support amount (such as reducing to 30%) or reducing by another set amount (such a reducing by half again, or by another amount).
  • the ventilator selects to perform increase operation 218. In other words, if the set number of high pressure alarms is not met during high pressure decision operation 216, the ventilator increases percent support setting to the patient until the desired percent support setting is reached.
  • method 200 also includes increase operation 218.
  • the ventilator increases the reduced percent support to form an increased percent support setting.
  • the ventilator during increase operation 218 increases the prior utilized percent support setting by a predetermined amount after a predetermined amount of time or after a predetermined number of breaths until the desired percent support setting is reached at operation 220 or until set amount of high pressure alarms is reached at operation 216.
  • the percent support setting may be increased by 5% every breath or increased by 10% every two breaths.
  • the ventilator may also increase current percent support setting by 6% every 400 ms. These example are not meant to be limiting.
  • the ventilator during increase operation 218 may increase the current percent support setting by any suitable amount at any suitable time until the desired percent support setting is reached.
  • the term "current percent support setting" refers to the percent support setting utilized to calculate the last delivered target airway pressure to the patient.
  • method 200 includes setting decision operation 220.
  • the ventilator compares the increased percent support setting to the desired percent support setting. If the ventilator determines at setting decision operation 220 that the increased support setting is equal to or greater than the desired percent support setting based on the comparison, the ventilator selects to perform normal delivery operation 206 again, with the desired percent support setting. If the ventilator determines at setting decision operation 220 that the increased support setting is less than the desired percent support setting based on the comparison, the ventilator selects to perform increased delivery operation 222 again.
  • the ventilator calculates a target airway pressure based on the increased percent support setting and the one or more patient parameters (or the current patient effort determined therefrom) received from parameter receiving operation 204.
  • the ventilator at increased delivery operation 222 calculates or determines a patient effort based on one or more received patient parameters, such as estimated patient compliance and flow rate.
  • the ventilator delivers to the patient the target airway pressure calculated based on the increased percent support setting from operation 218.
  • the ventilator After the performance of increased delivery operation 222, the ventilator performs high pressure decision operation 216 again. In the event that a high pressure alarm occurs or that a high pressure limit is reached by the ventilator during the reduced delivery operation 214 or the increased delivery operation 222, the ventilator truncates the delivery of the target airway pressure, such that only a portion of the target airway pressure calculated based on the increased percent support setting or the reduced percent support setting is delivered to the patient. Once the high pressure limit is reached by the ventilator (or the ventilator delivers the high pressure limit to the patient), the ventilator immediately stops inspiration and begins exhalation to prevent any more pressure from being delivered to the patient during the reduced delivery operation 214 or the increased delivery operation 222.
  • FIG. 3 is a flow diagram illustrating a method 300 for ventilating a patient with a ventilator that utilizes a HPC PA breath type, in accordance with aspects of the disclosure.
  • the HPC PA breath type delivers a target airway pressure calculated based on a percent support setting and/or the occurrence of high pressure alarm. For example, the HPC PA breath type adjusts a desired or set percent support setting in response to the detection of one or more high pressure alarms.
  • adjusting the percent support setting to prevent the occurrence of additional high pressure alarms improves the treatment of a patient on a ventilator, improves clinician use of the HPC PA breath type, and/or improves patient comfort during ventilation when compared to the use of traditional PA breath types that do not adjust the percent support setting or target airway pressure in response to the occurrence of a high pressure alarm.
  • method 300 includes a normal calculation operation 302, a normal delivery operation 304, an alarm decision operation 306, a reduction operation 308 and a reduction delivery operation 310. In some aspects, method 300 also includes operation 312 and/or operation 314.
  • the ventilator calculates a first target airway pressure based on a desired percent support setting.
  • the ventilator delivers the first target airway pressure to the patient.
  • the ventilator determines if a high pressure limit has been met or if a high pressure alarm has occurred.
  • the ventilator selects to perform normal calculate operation 302 again.
  • the ventilator selects to perform reduction operation 308.
  • the ventilator at normal delivery operation 304 only delivers a portion of the first target airway pressure because the first target airway pressure is truncated in response to an occurrence of a high pressure alarm.
  • the ventilator reduces the percent support setting to form a reduced percent support setting.
  • the ventilator calculates a second target airway pressure based on the reduced percent support setting and then delivers the second target airway pressure to the patient in the next subsequent breath.
  • the ventilator increases the reduced percent support setting after each delivered breath by a set amount to form incremental percent support settings until the desired percent support setting is reached or until another high pressure alarm is detected. In some aspects, the amount of increase is 5% or 10% every breath or every two breaths (or other number of breaths).
  • the ventilator calculates additional target airway pressures based on the current incremental percent support setting and delivers to the patient the additional target airway pressures during different breaths. When the percent support setting is reached during operation 314 of method 300 , the ventilator selects to perform operation 302 and 304 again instead of operation 314.
  • the ventilator during method 300 performs operation 306 continuously. As such, the ventilator continues to check for high pressure alarms during operations 310 and 314. If a high pressure alarm is detected during operations 310 and 314 during method 300 by the ventilator, the ventilator selects to perform operation 308 again. For example, if another high pressure alarm is detected by the ventilator, the ventilator reduces a current percent support setting to the reduced percent support setting, calculates a third target airway pressure based on the reduced percent support setting, and then delivers the third target airway pressure to the patient.
  • FIG. 4 is a flow diagram illustrating a method 400 for ventilating a patient with a ventilator that utilizes a HPC PA breath type, in accordance with aspects of the disclosure.
  • the method provides a way to automatically and temporarily reduce the amplification of breath delivered to the patient, to enable the patient to exert additional inspiratory effort during this temporary time period without triggering high pressure alarms that result in truncated breaths.
  • the method automatically returns to the prior amplification settings.
  • the method 400 includes ventilating a patient with first PA settings, at 401. This means delivering a proportional assist breath to a patient, with first PA settings such as a first percent support setting, a calculated pressure target (calculated based on patient effort and the first percent support setting), and high pressure alarm limit.
  • first PA settings such as a first percent support setting, a calculated pressure target (calculated based on patient effort and the first percent support setting), and high pressure alarm limit.
  • the method includes triggering a high pressure alarm during a first breath or first set of breaths, at 402. For example, this operation may occur where a patient makes a large effort, and the ventilator amplifies this effort at a high percent support setting, resulting in a target airway pressure that is at or above the high pressure limit.
  • the method may include identifying this alarm in a single breath, or in a set of breaths (such as in a certain number of consecutive breaths or in a certain number of non-consecutive breaths within a span, as described in more detail in reference to figures above).
  • the method includes automatically applying a reduction factor to create HPC-limited PA settings, at 403. This could include reducing the percent support setting (as described in more detail in reference to figures above) or reducing the calculated target airway pressure.
  • the target airway pressure could be reduced by a factor (such as reduced in half, or by a third) or by an absolute amount (such as by 10 cmH 2 O, or other value).
  • the method then includes ventilating the patient with the HPC-limited PA settings, in a second breath or second set of breaths, at 404.
  • the ventilator monitors for a stable period without additional high pressure alarms, such as a number of consecutive breaths without triggering an alarm.
  • the method includes releasing the reduction factor, at 406. This could include releasing the reduction factor entirely for the next breath, or incrementally releasing it over two or more breaths.
  • the method includes resuming PA ventilation at the first PA settings, at 407.
  • a method for ventilating a spontaneously inspiring patient includes ventilating the patient with a first proportional assist (PA) setting, triggering a high pressure alarm during a first breath or first set of breaths, applying a reduction factor to create an HPC-limited PA setting, ventilating the patient with the HPC-limited PA setting in a second breath or second set of breaths, releasing the reduction factor in a subsequent breath or set of breaths, and resuming ventilation with the first PA setting.
  • applying the reduction factor includes reducing a percent support setting.
  • applying the reduction factor includes reducing the calculated target airway pressure.
  • applying the reduction factor includes reducing an amplification setting.
  • a microprocessor-based ventilator that accesses a computer-readable medium having computer-executable instructions for performing the method of ventilating a patient with a medical ventilator is disclosed. This method includes repeatedly performing the steps disclosed in method 200 and/or method 300 and/or method 400 above and/or as illustrated in FIGS. 2 and/or 3 and/or 4.

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Claims (15)

  1. Système de ventilateur comprenant :
    un système générateur de pression (102) adapté à générer un flux de gaz respiratoire ;
    un système de tubulure de ventilation (130) comportant une interface patient (180) pour relier le système générateur de pression (102) à un patient (150) ;
    un ou plusieurs capteurs (107) couplés fonctionnellement à au moins l'un du système générateur de pression (102), du patient (150) et du système de tubulure de ventilation (130), dans lequel le ou les capteurs (107) génèrent une sortie indiquant un flux d'inspiration ;
    au moins un processeur (116) ; et
    une mémoire (112) pour stocker et coder des instructions exécutables par ordinateur qui, lorsqu'elles sont exécutées par l'au moins un processeur sont opérationnelles pour :
    calculer une première pression de voies respiratoires cible en fonction d'un réglage de support en pourcentage, administrer une partie de la première pression de voies respiratoires cible au patient (150) parce que la première pression de voies respiratoires cible est tronquée en réponse à une occurrence d'une alarme de haute pression,
    caractérisé en ce que :
    l'au moins un processeur est en outre opérationnel pour :
    en réponse à l'alarme de haute pression, réduire le réglage en pourcentage pour former un réglage de support en pourcentage réduit,
    calculer une deuxième pression de voies respiratoires cible en fonction du réglage de support en pourcentage réduit, et
    délivrer la deuxième pression de voies respiratoires cible au patient (150).
  2. Système selon la revendication 1, dans lequel l'au moins un processeur est en outre opérationnel pour :
    après que la deuxième pression de voies respiratoires cible a été délivrée au patient (150), augmenter le support en pourcentage réduit après chaque respiration délivrée d'une quantité prédéterminée pour former différents réglages de support en pourcentage incrémentiels jusqu'à ce que le réglage de support en pourcentage soit atteint ou jusqu'à ce qu'une autre alarme de haute pression soit détectée ;
    calculer des pressions de voies respiratoires cibles supplémentaires en fonction des réglages de support en pourcentage incrémentiels ; et
    délivrer les pressions de voies respiratoires cibles supplémentaires au patient (150) pendant différentes respirations
  3. Système selon la revendication 2, dans lequel l'au moins un processeur est en outre opérationnel pour :
    lorsque le réglage de support en pourcentage est atteint, calculer une troisième pression de voies respiratoires cible en fonction du réglage de support en pourcentage ; et
    délivrer la troisième pression de voies respiratoires cible au patient (150).
  4. Système selon la revendication 2, dans lequel la quantité prédéterminée est 5 %.
  5. Système selon la revendication 2, dans lequel la quantité prédéterminée est 10 %.
  6. Système selon la revendication 2, comprenant en outre dans lequel l'au moins un processeur est en outre opérationnel pour :
    détecter une autre alarme de haute pression ;
    en réponse à la détection de l'autre alarme de haute pression, réduire un réglage de support en pourcentage actuel au réglage de support en pourcentage réduit ;
    calculer une troisième pression de voies respiratoires cible en fonction du réglage de support en pourcentage réduit ; et délivrer la troisième pression de voies respiratoires cible au patient (150).
  7. Système selon la revendication 1, dans lequel l'au moins un processeur est en outre opérationnel pour : surveiller des alarmes de haute pression ; et
    déterminer qu'un nombre défini d'alarmes de haute pression consécutives s'est produit en réponse à la délivrance de la première pression cible de voies respiratoires en fonction de la surveillance des alarmes de haute pression, dans lequel
    la réduction du réglage en pourcentage est en réponse à l'occurrence du nombre défini d'alarmes de haute pression consécutives.
  8. Système selon la revendication 7, dans lequel l'au moins un processeur est en outre opérationnel pour : après que la deuxième pression cible de voies respiratoires a été délivrée au patient (150), augmenter le support en pourcentage réduit pour former un réglage de support en pourcentage accru ;
    calculer une troisième pression de voies respiratoires cible en fonction du réglage de support en pourcentage accru et du ou des paramètres de patient ; et
    délivrer une troisième pression de voies respiratoires cible au patient (150).
  9. Système selon la revendication 8, dans lequel l'au moins un processeur est en outre opérationnel pour : comparer le réglage de support en pourcentage souhaité au réglage de support en pourcentage accru ; déterminer que le réglage de support en pourcentage souhaité est le même que le réglage de support en pourcentage accru en fonction de la comparaison ;
    en réponse à la détermination, calculer une quatrième pression de voies respiratoires cible en fonction du réglage de support en pourcentage souhaité et du ou des paramètres de patient ; et
    délivrer une quatrième pression de voies respiratoires cible au patient (150).
  10. Système selon la revendication 8, dans lequel l'au moins un processeur est en outre opérationnel pour :
    après que la troisième pression cible de voies respiratoires a été délivrée au patient (150), comparer le réglage de support en pourcentage souhaité au réglage de support en pourcentage accru ;
    déterminer que le réglage de support en pourcentage accru est inférieur au réglage de support en pourcentage souhaité en fonction de la comparaison ; et
    en réponse à la détermination, augmenter le réglage de support en pourcentage accru pour former un réglage de support en pourcentage mis à jour ;
    calculer une quatrième pression de voies respiratoires cible en fonction du réglage de support en pourcentage mis à jour et du ou des paramètres de patient ; et
    délivrer la quatrième pression de voies respiratoires cible au patient (150).
  11. Système selon la revendication 10, dans lequel l'au moins un processeur est en outre opérationnel pour :
    après que la quatrième pression de voies respiratoires cible a été délivrée au patient (150), comparer le réglage de support en pourcentage souhaité au réglage de support en pourcentage mis à jour ;
    déterminer que le réglage de support en pourcentage mis à jour est inférieur au réglage de support en pourcentage souhaité en fonction de la comparaison du réglage de support en pourcentage souhaité au réglage de support en pourcentage mis à jour ; et
    en réponse à la détermination que le réglage de support en pourcentage mis à jour est inférieur au réglage de support en pourcentage souhaité, augmenter le réglage de support en pourcentage mis à jour pour former un réglage de support en pourcentage modifié ; et
    délivrer une partie d'une cinquième pression de voies respiratoires cible au patient (150) en fonction du réglage de support en pourcentage modifié et du ou des paramètres de patient parce que la cinquième pression de voies respiratoires cible est tronquée en réponse à une occurrence d'une autre alarme de haute pression ;
    en réponse à l'occurrence de l'autre alarme de haute pression, réduire le réglage de support en pourcentage modifié au réglage de support en pourcentage réduit ;
    calculer une sixième pression de voies respiratoires cible en fonction du réglage de support en pourcentage réduit et du ou des paramètres de patient ; et
    délivrer la sixième pression de voies respiratoires cible au patient (150).
  12. Système selon la revendication 7, dans lequel :
    le réglage de support en pourcentage réduit est de 50 % ; ou
    le réglage de support en pourcentage souhaité est réduit par un pourcentage prédéterminé pour former le réglage de support en pourcentage réduit.
  13. Système selon la revendication 8, dans lequel
    l'augmentation du réglage de support en pourcentage réduit pour former le réglage de support en pourcentage accru comprend l'augmentation du réglage de support en pourcentage réduit de 5 % pour former le réglage de support en pourcentage accru ; ou
    l'augmentation du réglage de support en pourcentage réduit pour former le réglage de support en pourcentage accru comprend l'augmentation du réglage de support en pourcentage réduit de 10 % pour former le réglage de support en pourcentage accru.
  14. Système selon la revendication 8, dans lequel l'augmentation du réglage de support en pourcentage réduit pour former le réglage de support en pourcentage accru est effectuée après qu'un nombre prédéterminé de respirations ont été délivrées au patient (150) après que la deuxième pression de voies respiratoires cible a été délivrée au patient (150), dans lequel
    facultativement :
    le nombre prédéterminé de respirations est de 1 ou 2 respirations.
  15. Système selon la revendication 8, dans lequel l'augmentation du réglage de support en pourcentage réduit pour former le réglage de support en pourcentage accru est effectuée après une durée prédéterminée depuis la délivrance de la deuxième pression de voies respiratoires cible au patient (150).
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Families Citing this family (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102018008493A1 (de) * 2018-10-30 2020-04-30 Drägerwerk AG & Co. KGaA Transfereinheit, Beatmungsvorrichtung, Beatmungssystem sowie Verfahren zum Wechsel einer für einen Beatmungsvorgang eines Patienten verwendeten Beatmungsvorrichtung
US20230245768A1 (en) * 2022-02-02 2023-08-03 Covidien Lp Family ventilator dashboard for medical ventilator
US12485246B2 (en) 2022-07-22 2025-12-02 Covidien Lp Low-profile humidifier with removable flow channel

Family Cites Families (257)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4044763A (en) 1975-07-07 1977-08-30 Bird F M Ventilator and method
US4448192A (en) 1982-03-05 1984-05-15 Hewlett Packard Company Medical ventilator device parametrically controlled for patient ventilation
US4821709A (en) 1983-08-01 1989-04-18 Sensormedics Corporation High frequency ventilator and method
US4655213A (en) 1983-10-06 1987-04-07 New York University Method and apparatus for the treatment of obstructive sleep apnea
US4527557A (en) 1984-11-01 1985-07-09 Bear Medical Systems, Inc. Medical ventilator system
US4805612A (en) 1985-09-13 1989-02-21 Sensormedics Corporation High frequency ventilation
US4637385A (en) 1986-01-13 1987-01-20 Tibor Rusz Pulmonary ventilator controller
US5150291A (en) 1986-03-31 1992-09-22 Puritan-Bennett Corporation Respiratory ventilation apparatus
US4773411A (en) 1986-05-08 1988-09-27 Downs John B Method and apparatus for ventilatory therapy
US4805613A (en) 1986-05-23 1989-02-21 Bird F M Ventilator which can be readily transported for emergency situations
GB8704104D0 (en) 1987-02-21 1987-03-25 Manitoba University Of Respiratory system load apparatus
US4986268A (en) 1988-04-06 1991-01-22 Tehrani Fleur T Method and apparatus for controlling an artificial respirator
GB8913085D0 (en) 1989-06-07 1989-07-26 Whitwam James G Improvements in or relating to medical ventilators
US5632269A (en) 1989-09-22 1997-05-27 Respironics Inc. Breathing gas delivery method and apparatus
US5148802B1 (en) 1989-09-22 1997-08-12 Respironics Inc Method and apparatus for maintaining airway patency to treat sleep apnea and other disorders
US5239995A (en) 1989-09-22 1993-08-31 Respironics, Inc. Sleep apnea treatment apparatus
USRE35295E (en) 1989-09-22 1996-07-16 Respironics, Inc. Sleep apnea treatment apparatus
US5165398A (en) 1989-12-08 1992-11-24 Bird F M Ventilator and oscillator for use therewith and method
US5161525A (en) 1990-05-11 1992-11-10 Puritan-Bennett Corporation System and method for flow triggering of pressure supported ventilation
US5390666A (en) 1990-05-11 1995-02-21 Puritan-Bennett Corporation System and method for flow triggering of breath supported ventilation
US5237987A (en) 1990-06-07 1993-08-24 Infrasonics, Inc. Human lung ventilator system
GB9103419D0 (en) 1991-02-19 1991-04-03 Univ Manitoba Piston-based ventilator design and operation
US6629527B1 (en) 1991-10-17 2003-10-07 Respironics, Inc. Sleep apnea treatment apparatus
US7013892B2 (en) 1991-11-01 2006-03-21 Ric Investments, Llc Sleep apnea treatment apparatus
US5271389A (en) 1992-02-12 1993-12-21 Puritan-Bennett Corporation Ventilator control system that generates, measures, compares, and corrects flow rates
US5353788A (en) 1992-09-21 1994-10-11 Miles Laughton E Cardio-respiratory control and monitoring system for determining CPAP pressure for apnea treatment
US5438980A (en) 1993-01-12 1995-08-08 Puritan-Bennett Corporation Inhalation/exhalation respiratory phase detection circuit
US6758217B1 (en) 1993-02-05 2004-07-06 University Of Manitoba Control of airway pressure during mechanical ventilation
GB9302291D0 (en) 1993-02-05 1993-03-24 Univ Manitoba Method for improved control of airway pressure during mechanical ventilation
US5398676A (en) 1993-09-30 1995-03-21 Press; Roman J. Portable emergency respirator
EP2305116A1 (fr) 1993-11-05 2011-04-06 ResMed Ltd. Dispositif de commande pour le traitment par ventilation en pression positive continue
US6675797B1 (en) 1993-11-05 2004-01-13 Resmed Limited Determination of patency of the airway
BR9304638A (pt) 1993-12-06 1995-07-25 Intermed Equipamento Medico Ho Sistema de controle de ciclo respiratório
US5794615A (en) 1994-06-03 1998-08-18 Respironics, Inc. Method and apparatus for providing proportional positive airway pressure to treat congestive heart failure
US5535738A (en) 1994-06-03 1996-07-16 Respironics, Inc. Method and apparatus for providing proportional positive airway pressure to treat sleep disordered breathing
US6105575A (en) 1994-06-03 2000-08-22 Respironics, Inc. Method and apparatus for providing positive airway pressure to a patient
US6932084B2 (en) 1994-06-03 2005-08-23 Ric Investments, Inc. Method and apparatus for providing positive airway pressure to a patient
AU683753B2 (en) 1994-07-06 1997-11-20 Teijin Limited An apparatus for assisting in ventilating the lungs of a patient
ATE407716T1 (de) 1994-10-14 2008-09-15 Bird Products Corp Tragbares, mechanisches und mit einem umlaufverdichter angetriebenes beatmungsgerät
FI945649A0 (fi) 1994-11-30 1994-11-30 Instrumentarium Oy Foerfarande och anordning foer indentifiering av en koppling vid ventilation av en patient
SE9500275L (sv) 1995-01-26 1996-07-27 Siemens Elema Ab Metod och apparat för att bestämma en överföringsfunktion för ett anslutningssystem
JPH10500347A (ja) 1995-02-08 1998-01-13 ピューリタン−ベネット・コーポレイション ベンチレータ用ガス混合装置
US5598838A (en) 1995-04-07 1997-02-04 Healthdyne Technologies, Inc. Pressure support ventilatory assist system
US5513631A (en) 1995-07-21 1996-05-07 Infrasonics, Inc. Triggering of patient ventilator responsive to a precursor signal
US6000396A (en) 1995-08-17 1999-12-14 University Of Florida Hybrid microprocessor controlled ventilator unit
DE69618133T2 (de) 1995-10-13 2002-07-11 Siemens-Elema Ab, Solna Trachealtubus und Vorrichtung für Beatmungssysteme
US6135105A (en) 1995-10-20 2000-10-24 University Of Florida Lung classification scheme, a method of lung class identification and inspiratory waveform shapes
AUPN616795A0 (en) 1995-10-23 1995-11-16 Rescare Limited Ipap duration in bilevel cpap or assisted respiration treatment
SE9504311D0 (sv) 1995-12-01 1995-12-01 Siemens Elema Ab Breathing apparatus
US6041777A (en) 1995-12-01 2000-03-28 Alliance Pharmaceutical Corp. Methods and apparatus for closed-circuit ventilation therapy
US6463930B2 (en) 1995-12-08 2002-10-15 James W. Biondi System for automatically weaning a patient from a ventilator, and method thereof
US5735267A (en) 1996-03-29 1998-04-07 Ohmeda Inc. Adaptive control system for a medical ventilator
US5692497A (en) 1996-05-16 1997-12-02 Children's Medical Center Corporation Microprocessor-controlled ventilator system and methods
US5975081A (en) 1996-06-21 1999-11-02 Northrop Grumman Corporation Self-contained transportable life support system
SE9602913D0 (sv) 1996-08-02 1996-08-02 Siemens Elema Ab Ventilator system and method of operating a ventilator system
US5752506A (en) 1996-08-21 1998-05-19 Bunnell Incorporated Ventilator system
US5694923A (en) 1996-08-30 1997-12-09 Respironics, Inc. Pressure control in a blower-based ventilator
SE9603249D0 (sv) 1996-09-06 1996-09-06 Siemens Elema Ab Anordning för kompensering av flödesmotstånd vid ventilator/respirator
AUPO247496A0 (en) 1996-09-23 1996-10-17 Resmed Limited Assisted ventilation to match patient respiratory need
US6371113B1 (en) 1996-10-10 2002-04-16 Datex-Ohmeda, Inc. Zero flow pause during volume ventilation
US5884622A (en) 1996-12-20 1999-03-23 University Of Manitoba Automatic determination of passive elastic and resistive properties of the respiratory system during assisted mechanical ventilation
US8932227B2 (en) 2000-07-28 2015-01-13 Lawrence A. Lynn System and method for CO2 and oximetry integration
US5881717A (en) 1997-03-14 1999-03-16 Nellcor Puritan Bennett Incorporated System and method for adjustable disconnection sensitivity for disconnection and occlusion detection in a patient ventilator
US5881723A (en) 1997-03-14 1999-03-16 Nellcor Puritan Bennett Incorporated Ventilator breath display and graphic user interface
GB9709275D0 (en) 1997-05-07 1997-06-25 Hayek Zamir Fluid control valve and oscillator for producing a pressure waveform
SE513980C2 (sv) 1997-11-13 2000-12-04 Mincor Ab Sätt och anordning för bestämning av effektiv lungvolym
US6196222B1 (en) 1998-03-10 2001-03-06 Instrumentarium Corporation Tracheal gas insufflation delivery system for respiration equipment
AUPP240198A0 (en) 1998-03-17 1998-04-09 Resmed Limited An apparatus for supplying breathable gas
JP3945902B2 (ja) 1998-03-31 2007-07-18 スズキ株式会社 人工呼吸器
SE9801175D0 (sv) 1998-04-03 1998-04-03 Innotek Ab Metod och apparat för optimering av mekanisk ventilation med utgångspunkt från simulering av ventilatonsprocessen efter studium av andningsorganens fysiologi
AUPP370198A0 (en) 1998-05-25 1998-06-18 Resmed Limited Control of the administration of continuous positive airway pressure treatment
CA2239673A1 (fr) 1998-06-04 1999-12-04 Christer Sinderby Ajustements automatiques des niveaux appliques de soutien ventilatoires et coup d'oeil extrinseque d'efficience neuro-ventilatoire par controle en boucle fermee
SE9802122D0 (sv) 1998-06-15 1998-06-15 Siemens Elema Ab Förfarande för bestämning av volym
US6631716B1 (en) 1998-07-17 2003-10-14 The Board Of Trustees Of The Leland Stanford Junior University Dynamic respiratory control
US6257234B1 (en) 1998-08-21 2001-07-10 Respironics, Inc. Apparatus and method for determining respiratory mechanics of a patient and for controlling a ventilator based thereon
SE9802827D0 (sv) 1998-08-25 1998-08-25 Siemens Elema Ab Ventilator
US6588422B1 (en) 1999-01-15 2003-07-08 Resmed Ltd. Method and apparatus to counterbalance intrinsic positive end expiratory pressure
ATE255931T1 (de) 1999-01-29 2003-12-15 Siemens Elema Ab Nichtinvasives verfahren zur optimierung der beatmung atelektatischer lungen
USRE40402E1 (en) 1999-01-29 2008-06-24 Maquet Critical Care Ab Non-invasive method for optimizing the respiration of atelectatic lungs
CA2362164A1 (fr) 1999-02-03 2000-08-10 Paul Bradford Blanch Methode et appareil permettant d'annuler un travail ventilatoire impose
US6467477B1 (en) 1999-03-26 2002-10-22 Respironics, Inc. Breath-based control of a therapeutic treatment
US6240919B1 (en) 1999-06-07 2001-06-05 Macdonald John J. Method for providing respiratory airway support pressure
US6672300B1 (en) 1999-06-23 2004-01-06 Graham Cameron Grant Respiration assistor
ES2243282T3 (es) 1999-06-30 2005-12-01 University Of Florida Research Foundation, Inc. Sistema de monitorizacion de ventilador.
US20070000494A1 (en) 1999-06-30 2007-01-04 Banner Michael J Ventilator monitor system and method of using same
BR9903858B1 (pt) 1999-08-05 2009-05-05 mini ventilador pulmonar mecánico pneumático.
US6758216B1 (en) 1999-09-15 2004-07-06 Resmed Limited Ventilatory assistance using an external effort sensor
DE60043362D1 (de) 1999-09-15 2009-12-31 Resmed Ltd Synchronisierung einer Beatmungsvorrichtung mittels Doppelphasensensoren
US6910480B1 (en) 1999-09-15 2005-06-28 Resmed Ltd. Patient-ventilator synchronization using dual phase sensors
US6557554B1 (en) 1999-10-29 2003-05-06 Suzuki Motor Corporation High-frequency oscillation artificial respiration apparatus
US7516742B2 (en) 1999-11-24 2009-04-14 Cardinal Health 207, Inc. Method and apparatus for delivery of inhaled nitric oxide to spontaneous-breathing and mechanically-ventilated patients with intermittent dosing
SE9904645D0 (sv) 1999-12-17 1999-12-17 Siemens Elema Ab High Frequency Oscillator Ventilator
DE19961253C1 (de) 1999-12-18 2001-01-18 Draeger Medizintech Gmbh Beatmungsgerät für unterschiedliche Beatmungsformen
JP3721912B2 (ja) 2000-01-11 2005-11-30 スズキ株式会社 高頻度人工呼吸器
SE0000206D0 (sv) 2000-01-25 2000-01-25 Siemens Elema Ab High frequency oscillator ventilator
US6629934B2 (en) 2000-02-02 2003-10-07 Healthetech, Inc. Indirect calorimeter for medical applications
US6553992B1 (en) 2000-03-03 2003-04-29 Resmed Ltd. Adjustment of ventilator pressure-time profile to balance comfort and effectiveness
DE10014427A1 (de) 2000-03-24 2001-10-04 Weinmann G Geraete Med Verfahren zur Steuerung eines Beatmungsgerätes sowie Vorrichtung zur Überwachung
US6532956B2 (en) 2000-03-30 2003-03-18 Respironics, Inc. Parameter variation for proportional assist ventilation or proportional positive airway pressure support devices
JP3713240B2 (ja) 2000-04-26 2005-11-09 ユニヴァーシティ オブ マニトーバ 換気支援中の呼吸器系の抵抗を求める装置
US6532960B1 (en) 2000-07-10 2003-03-18 Respironics, Inc. Automatic rise time adjustment for bi-level pressure support system
US6439229B1 (en) 2000-08-08 2002-08-27 Newport Medical Instruments, Inc. Pressure support ventilation control system and method
US6557553B1 (en) 2000-09-05 2003-05-06 Mallinckrodt, Inc. Adaptive inverse control of pressure based ventilation
JP4246365B2 (ja) 2000-09-21 2009-04-02 日本特殊陶業株式会社 酸素濃縮器及びその制御装置並びに記録媒体
US6626175B2 (en) 2000-10-06 2003-09-30 Respironics, Inc. Medical ventilator triggering and cycling method and mechanism
US6622726B1 (en) 2000-10-17 2003-09-23 Newport Medical Instruments, Inc. Breathing apparatus and method
DE10103810A1 (de) 2001-01-29 2002-08-01 Map Gmbh Vorrichtung zur Zufuhr eines Atemgases
US7040321B2 (en) 2001-03-30 2006-05-09 Microcuff Gmbh Method for controlling a ventilator, and system therefor
EP1399209B1 (fr) 2001-05-23 2016-08-17 ResMed Limited Synchronisation d'un respirateur avec la respiration d'un patient
US7246618B2 (en) 2001-06-21 2007-07-24 Nader Maher Habashi Ventilation method and control of a ventilator based on same
CN1313172C (zh) 2001-07-19 2007-05-02 雷斯姆德公司 病人压力支持通气的方法及设备
IL145461A (en) 2001-09-16 2006-09-05 Alyn Woldenberg Family Hospita Breathing and coughing device
US7938114B2 (en) 2001-10-12 2011-05-10 Ric Investments Llc Auto-titration bi-level pressure support system and method of using same
US7032589B2 (en) 2002-01-23 2006-04-25 The Johns Hopkins University Portable ventilator
US6968842B1 (en) 2002-04-03 2005-11-29 Ric Investments, Inc. Measurement of a fluid parameter in a pressure support system
DE10217762C1 (de) 2002-04-20 2003-04-10 Draeger Medical Ag Verfahren und Vorrichtung zur Steuerung der Atemgasversorgung
ATE439157T1 (de) 2002-06-27 2009-08-15 Yrt Ltd Vorrichtung zur überwachung und verbesserung der wechselwirkung z wischen patienten und beatmungsgerät
EP1534131B1 (fr) 2002-08-30 2016-10-26 University of Florida Research Foundation, Inc. Procede et appareil permettant de prevoir le travail de respiration
US8672858B2 (en) 2002-08-30 2014-03-18 University Of Florida Research Foundation, Inc. Method and apparatus for predicting work of breathing
US7682312B2 (en) 2002-09-20 2010-03-23 Advanced Circulatory Systems, Inc. System for sensing, diagnosing and treating physiological conditions and methods
AU2003277435A1 (en) 2002-10-11 2004-05-04 The Regents Of The University Of California Bymixer apparatus and method for fast-response, adjustable measurement of mixed gas fractions in ventilation circuits
DE10248590B4 (de) 2002-10-17 2016-10-27 Resmed R&D Germany Gmbh Verfahren und Vorrichtung zur Durchführung einer signalverarbeitenden Betrachtung eines mit der Atmungstätigkeit einer Person im Zusammenhang stehenden Messsignales
US7708016B2 (en) 2002-11-12 2010-05-04 Inovo, Inc. Gas conserving regulator
GB2396426B (en) 2002-12-21 2005-08-24 Draeger Medical Ag Artificial respiration system
US6954702B2 (en) 2003-02-21 2005-10-11 Ric Investments, Inc. Gas monitoring system and sidestream gas measurement system adapted to communicate with a mainstream gas measurement system
NZ577553A (en) 2003-02-21 2011-01-28 Resmed Ltd Nasal assembly
AU2003901042A0 (en) 2003-03-07 2003-03-20 Resmed Limited Back-up rate for a ventilator
US7819815B2 (en) 2003-03-14 2010-10-26 Yrt Limited Synchrony between end of ventilator cycles and end of patient efforts during assisted ventilation
DE102004014619A1 (de) 2003-03-24 2005-03-17 Weinmann Geräte für Medizin GmbH + Co. KG Verfahren und Vorrichtung zur Erkennung von Leckagen bei Einrichtungen zum Zuführen von Atemgasen
US7275540B2 (en) 2003-04-22 2007-10-02 Medi-Physics, Inc. MRI/NMR-compatible, tidal volume control and measurement systems, methods, and devices for respiratory and hyperpolarized gas delivery
IL155955A0 (en) 2003-05-15 2003-12-23 Widemed Ltd Adaptive prediction of changes of physiological/pathological states using processing of biomedical signal
DE10337138A1 (de) 2003-08-11 2005-03-17 Freitag, Lutz, Dr. Verfahren und Anordnung zur Atmungsunterstützung eines Patienten sowie Luftröhrenprothese und Katheter
AU2003903139A0 (en) 2003-06-20 2003-07-03 Resmed Limited Breathable gas apparatus with humidifier
US7152598B2 (en) 2003-06-23 2006-12-26 Invacare Corporation System and method for providing a breathing gas
US7621270B2 (en) 2003-06-23 2009-11-24 Invacare Corp. System and method for providing a breathing gas
FR2858236B1 (fr) 2003-07-29 2006-04-28 Airox Dispositif et procede de fourniture de gaz respiratoire en pression ou en volume
US7678061B2 (en) 2003-09-18 2010-03-16 Cardiac Pacemakers, Inc. System and method for characterizing patient respiration
US7241269B2 (en) 2003-09-02 2007-07-10 Respiratory Management Technology Apparatus and method for delivery of an aerosol
US7725152B2 (en) 2003-09-12 2010-05-25 Textronics, Inc. Extended optical range system for monitoring motion of a member
US20070135724A1 (en) 2003-10-17 2007-06-14 Ujhazy Anthony J Methods and apparatus for heart failure treatment
US7802571B2 (en) 2003-11-21 2010-09-28 Tehrani Fleur T Method and apparatus for controlling a ventilator
US8011365B2 (en) 2003-12-29 2011-09-06 Resmed Limited Mechanical ventilation in the presence of sleep disordered breathing
WO2005065757A1 (fr) 2004-01-07 2005-07-21 Resmed Ltd Procedes permettant d'obtenir une detente de pression expiratoire dans un traitement par pression positive expiratoire
US7697990B2 (en) 2004-02-20 2010-04-13 Resmed Limited Method and apparatus for detection and treatment of respiratory disorder by implantable device
US8794236B2 (en) 2004-02-25 2014-08-05 Resmed Limited Cardiac monitoring and therapy using a device for providing pressure treatment of sleep disordered breathing
US7751894B1 (en) 2004-03-04 2010-07-06 Cardiac Pacemakers, Inc. Systems and methods for indicating aberrant behavior detected by an implanted medical device
BRPI0508896A (pt) 2004-03-18 2007-09-11 Helicor Inc métodos e dispositivos para aliviar o estresse
US7267121B2 (en) 2004-04-20 2007-09-11 Aerogen, Inc. Aerosol delivery apparatus and method for pressure-assisted breathing systems
JP5175090B2 (ja) 2004-04-20 2013-04-03 ノバルティス アーゲー 従圧式呼吸システム
SE0401208D0 (sv) 2004-05-10 2004-05-10 Breas Medical Ab Multilevel ventilator
JP2008501445A (ja) 2004-06-04 2008-01-24 アイノゲン、インコーポレイテッド 治療用ガスを患者に送出するためのシステム及び方法
ITRM20040323A1 (it) 2004-06-30 2004-09-30 Cosmed Engineering S R L Dispositivo di misurazione del consumo di ossigeno.
EP1778326B1 (fr) 2004-07-08 2011-05-25 Breas Medical AB Dispositif de declenchement d'energie
US7690378B1 (en) 2004-07-21 2010-04-06 Pacesetter, Inc. Methods, systems and devices for monitoring respiratory disorders
WO2006037021A2 (fr) 2004-09-24 2006-04-06 Roger Lee Heath Procede, appareil et systeme de maintien des fonctions vitales et de reanimation
US7717110B2 (en) 2004-10-01 2010-05-18 Ric Investments, Llc Method and apparatus for treating Cheyne-Stokes respiration
EP1804873B1 (fr) 2004-10-06 2020-12-30 ResMed Pty Ltd Appareil pour la fourniture d'une thérapie à pression positive
WO2006079152A1 (fr) 2004-10-20 2006-08-03 Resmed Limited Procede et dispositif de detection des efforts inspiratoires inefficaces et amelioration de l'interaction patient-ventilateur
US7455717B2 (en) 2004-10-25 2008-11-25 Invacare Corporation Apparatus and method of providing concentrated product gas
WO2006050384A2 (fr) 2004-11-01 2006-05-11 Salter Labs Systeme et procede permettant de conserver une alimentation en oxygene tout en maintenant la saturation
US20060155336A1 (en) 2005-01-13 2006-07-13 Heath Roger L Medical resuscitation system and patient information module
DE102005010488A1 (de) 2005-03-04 2006-09-07 Map Medizin-Technologie Gmbh Vorrichtung zur Verabreichung eines Atemgases und Verfahren zur Einstellung zumindest zeitweise alternierender Atemgasdrücke
US8528551B2 (en) 2005-06-14 2013-09-10 Resmed Limited Acclimatization therapy for first time users
US20070044799A1 (en) 2005-07-08 2007-03-01 Hete Bernie F Modular oxygen regulator system and respiratory treatment system
US20070045152A1 (en) 2005-08-01 2007-03-01 Resmed Limited Storage system for an apparatus that delivers breathable gas to a patient
US7731663B2 (en) 2005-09-16 2010-06-08 Cardiac Pacemakers, Inc. System and method for generating a trend parameter based on respiration rate distribution
CA2623756A1 (fr) 2005-09-20 2007-03-29 Lutz Freitag Systemes, procedes et appareils destine a l'aide respiratoire d'un patient
US7305988B2 (en) 2005-12-22 2007-12-11 The General Electric Company Integrated ventilator nasal trigger and gas monitoring system
WO2007102866A2 (fr) 2005-12-08 2007-09-13 Ric Investments, Llc Respirateur adaptable pour une utilisation avec un circuit à double branche ou à branche unique
US7617824B2 (en) 2005-12-08 2009-11-17 Ric Investments, Llc Ventilator adaptable for use with either a dual-limb circuit or a single-limb circuit
US7662105B2 (en) 2005-12-14 2010-02-16 Cardiac Pacemakers, Inc. Systems and methods for determining respiration metrics
US7509957B2 (en) 2006-02-21 2009-03-31 Viasys Manufacturing, Inc. Hardware configuration for pressure driver
US7810497B2 (en) 2006-03-20 2010-10-12 Ric Investments, Llc Ventilatory control system
US8021310B2 (en) 2006-04-21 2011-09-20 Nellcor Puritan Bennett Llc Work of breathing display for a ventilation system
US7762252B2 (en) 2006-04-26 2010-07-27 Mine Safety Appliances Company Devices, systems and methods for operation of breathing apparatuses in multiple modes
CN101484202B (zh) 2006-05-12 2013-12-04 Yrt有限公司 产生反映患者在供氧支持下呼吸工作的信号的方法和装置
US7803117B2 (en) 2006-05-12 2010-09-28 Suunto Oy Method, device and computer program product for monitoring the physiological state of a person
US20070272241A1 (en) 2006-05-12 2007-11-29 Sanborn Warren G System and Method for Scheduling Pause Maneuvers Used for Estimating Elastance and/or Resistance During Breathing
US7763097B2 (en) 2006-06-08 2010-07-27 University of Pittsburgh—of the Commonwealth System of Higher Education Devices, systems and methods for reducing the concentration of a chemical entity in fluids
WO2007147069A2 (fr) 2006-06-14 2007-12-21 Advanced Brain Monitoring, Inc. Procédé pour mesurer une pression veineuse centrale ou un effort respiratoire
US7678058B2 (en) 2006-06-22 2010-03-16 Cardiac Pacemakers, Inc. Apnea type determining apparatus and method
US9010327B2 (en) 2006-06-30 2015-04-21 Breas Medical Ab Energy relief control in a mechanical ventilator
US9027560B2 (en) 2006-07-10 2015-05-12 Loma Linda University Breathing gas delivery system and method
US20080011301A1 (en) 2006-07-12 2008-01-17 Yuancheng Qian Out flow resistance switching ventilator and its core methods
US7556038B2 (en) 2006-08-11 2009-07-07 Ric Investments, Llc Systems and methods for controlling breathing rate
US8322339B2 (en) 2006-09-01 2012-12-04 Nellcor Puritan Bennett Llc Method and system of detecting faults in a breathing assistance device
US8646447B2 (en) 2006-11-13 2014-02-11 Resmed Limited Systems, methods, and/or apparatuses for non-invasive monitoring of respiratory parameters in sleep disordered breathing
US8020558B2 (en) 2007-01-26 2011-09-20 Cs Medical, Inc. System for providing flow-targeted ventilation synchronized to a patient's breathing cycle
US8789528B2 (en) 2007-02-12 2014-07-29 Ric Investments, Llc Pressure support method with automatic comfort feature modification
US8960193B2 (en) 2007-02-16 2015-02-24 General Electric Company Mobile medical ventilator
US20080216833A1 (en) 2007-03-07 2008-09-11 Pujol J Raymond Flow Sensing for Gas Delivery to a Patient
DE102009013205A1 (de) 2009-03-17 2010-09-23 Dolphys Technologies B.V. Jet-Ventilationskatheter, insbesondere zur Beatmung eines Patienten
EP1972274B1 (fr) 2007-03-20 2015-12-30 Drägerwerk AG & Co. KGaA Procédé et appareil pour déterminer la résistance du système respiratoire d'un patient
CA2688555C (fr) 2007-05-30 2021-11-23 Gilbert Jacobus Kuypers Ameliorations apportees aux appareils de reanimation
US20080295839A1 (en) 2007-06-01 2008-12-04 Habashi Nader M Ventilator Apparatus and System of Ventilation
KR100903172B1 (ko) 2007-06-04 2009-06-17 충북대학교 산학협력단 호흡신호를 무선으로 감지하기 위한 방법 및 이를 수행하기 위한 장치
US9743859B2 (en) 2007-06-15 2017-08-29 Cardiac Pacemakers, Inc. Daytime/nighttime respiration rate monitoring
EP2017586A1 (fr) 2007-07-20 2009-01-21 Map-Medizintechnologie GmbH Moniteur pour appareil de CPAP/ventilateur
US8475340B2 (en) 2007-07-25 2013-07-02 Montefiore Medical Center Hypoxic conditioning in patients with exercise limiting conditions
US8235042B2 (en) 2007-08-31 2012-08-07 Wet Nose Technologies, Llc Exhalatory pressure device and system thereof
CN101380233B (zh) 2007-09-05 2010-12-22 深圳迈瑞生物医疗电子股份有限公司 基于呼吸力学模块的呼吸功实时监测方法及监测装置
DE102007052897B4 (de) 2007-11-07 2013-02-21 Dräger Medical GmbH Verfahren zum automatischen Steuern eines Beatmungssystems sowie zugehöriges Beatmungssystem
CA2706376C (fr) 2007-11-20 2016-01-12 Avon Protection Systems, Inc. Respirateur purificateur d'air alimente modulaire
DE102007062214C5 (de) 2007-12-21 2017-12-21 Drägerwerk AG & Co. KGaA Verfahren zum automatischen Steuern eines Beatmungssystems sowie zugehörige Beatmungsvorrichtung
JP5535938B2 (ja) 2008-01-11 2014-07-02 コーニンクレッカ フィリップス エヌ ヴェ 人工呼吸特性の患者制御
US8307827B2 (en) 2008-03-10 2012-11-13 University Of Florida Research Foundation, Inc. Automated inspiratory muscle training for patients receiving mechanical ventilation
US8272379B2 (en) 2008-03-31 2012-09-25 Nellcor Puritan Bennett, Llc Leak-compensated flow triggering and cycling in medical ventilators
US8267085B2 (en) 2009-03-20 2012-09-18 Nellcor Puritan Bennett Llc Leak-compensated proportional assist ventilation
US8746248B2 (en) 2008-03-31 2014-06-10 Covidien Lp Determination of patient circuit disconnect in leak-compensated ventilatory support
US20100152600A1 (en) 2008-04-03 2010-06-17 Kai Sensors, Inc. Non-contact physiologic motion sensors and methods for use
JP2011522621A (ja) 2008-06-06 2011-08-04 ネルコー ピューリタン ベネット エルエルシー 患者の努力に比例した換気のためのシステムおよび方法
WO2010028150A1 (fr) 2008-09-04 2010-03-11 Nellcor Puritan Bennett Llc Ventilateur avec fonction de purge commandée
US8551006B2 (en) 2008-09-17 2013-10-08 Covidien Lp Method for determining hemodynamic effects
US8424520B2 (en) 2008-09-23 2013-04-23 Covidien Lp Safe standby mode for ventilator
US20100071696A1 (en) 2008-09-25 2010-03-25 Nellcor Puritan Bennett Llc Model-predictive online identification of patient respiratory effort dynamics in medical ventilators
CZ19690U1 (cs) 2009-01-23 2009-06-08 Ceské vysoké ucení technické v Praze, Zarízení pro detekci pohybu bránice
US8428672B2 (en) 2009-01-29 2013-04-23 Impact Instrumentation, Inc. Medical ventilator with autonomous control of oxygenation
WO2010088543A1 (fr) 2009-01-29 2010-08-05 Aylsworth Alonzo C Procédé et système pour détecter une fuite buccale lors de l'application d'une pression positive dans les voies respiratoires
US20100199991A1 (en) 2009-02-06 2010-08-12 Hartwell Medical Corporation Ventilatory support and resuscitation device and associated method
US8761852B2 (en) 2009-02-18 2014-06-24 Nonin Medical, Inc. Disposable oximeter device
US20100234750A1 (en) 2009-02-19 2010-09-16 Nexense Ltd. Apparatus and method for detecting breathing disorders
US8607796B2 (en) 2009-02-27 2013-12-17 Airway Technologies, Llc Apparatus and method for coupling an oral appliance to a gas delivery device
US8424521B2 (en) 2009-02-27 2013-04-23 Covidien Lp Leak-compensated respiratory mechanics estimation in medical ventilators
US9164168B2 (en) 2009-03-20 2015-10-20 Wright State University Systems for detecting movement of a target
US8418691B2 (en) 2009-03-20 2013-04-16 Covidien Lp Leak-compensated pressure regulated volume control ventilation
JP5351583B2 (ja) 2009-03-30 2013-11-27 日本光電工業株式会社 呼吸波形解析装置
US8608656B2 (en) 2009-04-01 2013-12-17 Covidien Lp System and method for integrating clinical information to provide real-time alerts for improving patient outcomes
JP5575223B2 (ja) 2009-04-02 2014-08-20 ブリーズ・テクノロジーズ・インコーポレーテッド 非侵襲性換気システム、患者の気道閉塞を少なくするシステムおよび睡眠時無呼吸を治療するデバイス
CA2697592C (fr) 2009-04-08 2013-11-05 Anurag Sharma H K Dispositif de regulation de la dilution d'oxygene, reglable en fonction de la demande, pour utilisation dans des aeronefs
JP5639152B2 (ja) 2009-04-22 2014-12-10 レスメド・リミテッドＲｅｓＭｅｄＬｉｍｉｔｅｄ 非同期性の検出
US8408203B2 (en) 2009-04-30 2013-04-02 General Electric Company System and methods for ventilating a patient
US8701665B2 (en) 2009-07-25 2014-04-22 Fleur T Tehrani Automatic control system for mechanical ventilation for active or passive subjects
US8789529B2 (en) 2009-08-20 2014-07-29 Covidien Lp Method for ventilation
EP2473106B1 (fr) 2009-09-01 2014-12-17 Koninklijke Philips N.V. Système et procédé de quantification de la compliance pulmonaire chez un sujet en ventilation automatique
US8400290B2 (en) * 2010-01-19 2013-03-19 Covidien Lp Nuisance alarm reduction method for therapeutic parameters
US9592356B2 (en) 2010-09-10 2017-03-14 Koninklijke Philips N.V. System and method for identifying breathing transitions
US20140048072A1 (en) 2010-11-29 2014-02-20 Covidien Lp Ventilator-initiated prompt regarding detection of fluctuations in compliance
US9629971B2 (en) 2011-04-29 2017-04-25 Covidien Lp Methods and systems for exhalation control and trajectory optimization
MX2014002034A (es) 2011-08-25 2014-03-21 Koninkl Philips Nv Medicion de aireacion no invasiva.
US9364624B2 (en) 2011-12-07 2016-06-14 Covidien Lp Methods and systems for adaptive base flow
US9498589B2 (en) 2011-12-31 2016-11-22 Covidien Lp Methods and systems for adaptive base flow and leak compensation
US9993604B2 (en) * 2012-04-27 2018-06-12 Covidien Lp Methods and systems for an optimized proportional assist ventilation
US9375542B2 (en) 2012-11-08 2016-06-28 Covidien Lp Systems and methods for monitoring, managing, and/or preventing fatigue during ventilation
WO2014096996A1 (fr) 2012-12-18 2014-06-26 Koninklijke Philips N.V. Commande de pression inspiratoire dans une référence croisée de ventilation en mode volume à des applications associées
CN103893864B (zh) * 2012-12-26 2017-05-24 北京谊安医疗系统股份有限公司 一种涡轮呼吸机压力控制通气方法
US9358355B2 (en) 2013-03-11 2016-06-07 Covidien Lp Methods and systems for managing a patient move
US10165966B2 (en) 2013-03-14 2019-01-01 University Of Florida Research Foundation, Incorporated Methods and systems for monitoring resistance and work of breathing for ventilator-dependent patients
EP2968273A4 (fr) 2013-03-15 2016-08-31 Univ Nevada Méthodes de traitement de la dystrophie musculaire
JP6204086B2 (ja) 2013-06-28 2017-09-27 日本光電工業株式会社 呼吸状態判定装置
US10064583B2 (en) 2013-08-07 2018-09-04 Covidien Lp Detection of expiratory airflow limitation in ventilated patient
US9675771B2 (en) 2013-10-18 2017-06-13 Covidien Lp Methods and systems for leak estimation
US9839760B2 (en) 2014-04-11 2017-12-12 Vyaire Medical Capital Llc Methods for controlling mechanical lung ventilation
US9808591B2 (en) 2014-08-15 2017-11-07 Covidien Lp Methods and systems for breath delivery synchronization
US9950129B2 (en) 2014-10-27 2018-04-24 Covidien Lp Ventilation triggering using change-point detection
US10596343B2 (en) 2015-03-02 2020-03-24 Covidien Lp Oxygen sensor assembly for medical ventilator
US10765822B2 (en) 2016-04-18 2020-09-08 Covidien Lp Endotracheal tube extubation detection
AU2018353928B2 (en) 2017-11-14 2019-06-13 Covidien Lp Methods and systems for drive pressure spontaneous ventilation

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US20200078547A1 (en) 2020-03-12
WO2020051096A8 (fr) 2020-10-08

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